The Final Diagnosis by Arthur Hailey Read Free Book Online Page B

saw the girl with the handkerchief flinch; if she was going to vomit he hoped it wouldn’t be in here. He kept the blade cutting until the top of the skull was severed. He put down the saw. George Rinne would remove the blood from it when he cleaned all the instruments later. Now McNeil carefully pried loose the skull, exposing the soft membrane covering the brain beneath. Again he glanced at the nurses. They were standing up to it well; if they could take this they could take anything.
    With the bony portion of the skull removed, McNeil took sharp scissors and opened the large vein—the superior sagittal sinus—which ran from front to rear along the center of the membrane. The blood poured out, spilling over the scissors and his fingers. It was fluid blood, he noted; there was no sign of thrombosis. He inspected the membrane carefully, then cut and lifted it clear to expose the mass of brain beneath. Using a knife, he carefully severed the brain from the spinal cord and eased it out. Seddons joined him, holding a glass jar half full of formalin, and McNeil gently lowered the brain into it.
    Watching McNeil, his hands steady and competent, Seddons found himself wondering again what went on in the pathology resident’s mind. He had known McNeil for two years, first as a fellow resident, though senior to himself in the hospital’s pyramid system, and then more closely during his own few months in Pathology. Pathology had interested Seddons; he was glad, though, it was not his own chosen specialty. He had never had second thoughts about his personal choice of surgery and would be glad when he went back to it in a few weeks’ time. In contrast to this domain of the dead the operating room was a territory of the living. It was pulsing and alive; there was a poetry of motion, a sense of achievement he knew he could never find here. Each to his own, he thought, and pathology for the pathologists.
    There was something else about pathology. You could lose your sense of reality, your awareness that medicine was of and for human beings. This brain now . . . Seddons found himself acutely aware that just a few hours ago it was the thinking center of a man. It had been coordinator of the senses—touch, smell, sight, taste. It had held thoughts, known love, fear, triumph. Yesterday, possibly even today, it could have told the eyes to cry, the mouth to drool. He had noticed the dead man was listed as a civil engineer. This, then, was a brain that had used mathematics, understood stresses, devised construction methods, perhaps had built houses, a highway, a water works, a cathedral—legacies from this brain for other humans to live with and use. But what was the brain now?—just a mass of tissue, beginning to be pickled and destined only to be sliced, examined, then incinerated.
    Seddons did not believe in God and he found it hard to understand how educated people could. Knowledge, science, thought—the more these advanced, the more improbable all religions became. But he did believe in what, for lack of better phrases, he thought of as “the spark of humanity, the credo of the individual.” As a surgeon, of course, he would not always deal with individuals; nor would he always know his patients, and even when he did he would lose awareness of them in concentrating on problems of technique. But long ago he had resolved never to forget that beneath everything was a patient—an individual. In his own training Seddons had seen the cocoon of personal isolation—a safeguard against close contact with individual patients—grow around others. Sometimes it was a defensive measure, a deliberate insulation of personal emotions and personal involvement. He felt strong enough himself, though, to get along without the insulation. Moreover, to make sure it did not grow, he forced himself sometimes to think and soliloquize as he was doing now. Perhaps it would surprise some of his friends who thought of Mike Seddons only as a buoyant